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Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage
BACKGROUND: Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated th...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483505/ https://www.ncbi.nlm.nih.gov/pubmed/33998241 http://dx.doi.org/10.1161/JAHA.120.020392 |
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author | Biffi, Alessandro Teo, Kay‐Cheong Castello, Juan Pablo Abramson, Jessica R. Leung, Ian Y. H. Leung, William C. Y. Wang, Yujie Kourkoulis, Christina Myserlis, Evangelos Pavlos Warren, Andrew D. Henry, Jonathan Chan, Koon‐Ho Cheung, Raymond T. F. Ho, Shu‐Leong Anderson, Christopher D. Gurol, M. Edip Viswanathan, Anand Greenberg, Steven M. Lau, Kui‐Kai Rosand, Jonathan |
author_facet | Biffi, Alessandro Teo, Kay‐Cheong Castello, Juan Pablo Abramson, Jessica R. Leung, Ian Y. H. Leung, William C. Y. Wang, Yujie Kourkoulis, Christina Myserlis, Evangelos Pavlos Warren, Andrew D. Henry, Jonathan Chan, Koon‐Ho Cheung, Raymond T. F. Ho, Shu‐Leong Anderson, Christopher D. Gurol, M. Edip Viswanathan, Anand Greenberg, Steven M. Lau, Kui‐Kai Rosand, Jonathan |
author_sort | Biffi, Alessandro |
collection | PubMed |
description | BACKGROUND: Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the frequency and prognostic impact of uncontrolled short‐term hypertension after ICH. METHODS AND RESULTS: We analyzed data from Massachusetts General Hospital (n=1305) and the University of Hong Kong (n=523). We classified hypertension as controlled, undertreated, or treatment resistant at 3 months after ICH and determined the following: (1) the risk factors for uncontrolled hypertension and (2) whether hypertension control at 3 months is associated with stroke recurrence and mortality. We followed 1828 survivors of ICH for a median of 46.2 months. Only 9 of 234 (4%) recurrent strokes occurred before 3 months after ICH. At 3 months, 713 participants (39%) had controlled hypertension, 755 (41%) had undertreated hypertension, and 360 (20%) had treatment‐resistant hypertension. Black, Hispanic, and Asian race/ethnicity and higher blood pressure at time of ICH increased the risk of uncontrolled hypertension at 3 months (all P<0.05). Uncontrolled hypertension at 3 months was associated with recurrent stroke and mortality during long‐term follow‐up (all P<0.05). CONCLUSIONS: Among survivors of ICH, >60% had uncontrolled hypertension at 3 months, with undertreatment accounting for the majority of cases. The 3‐month blood pressure measurements were associated with higher recurrent stroke risk and mortality. Black, Hispanic, and Asian survivors of ICH and those presenting with severe acute hypertensive response were at highest risk for uncontrolled hypertension. |
format | Online Article Text |
id | pubmed-8483505 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84835052021-10-06 Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage Biffi, Alessandro Teo, Kay‐Cheong Castello, Juan Pablo Abramson, Jessica R. Leung, Ian Y. H. Leung, William C. Y. Wang, Yujie Kourkoulis, Christina Myserlis, Evangelos Pavlos Warren, Andrew D. Henry, Jonathan Chan, Koon‐Ho Cheung, Raymond T. F. Ho, Shu‐Leong Anderson, Christopher D. Gurol, M. Edip Viswanathan, Anand Greenberg, Steven M. Lau, Kui‐Kai Rosand, Jonathan J Am Heart Assoc Original Research BACKGROUND: Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the frequency and prognostic impact of uncontrolled short‐term hypertension after ICH. METHODS AND RESULTS: We analyzed data from Massachusetts General Hospital (n=1305) and the University of Hong Kong (n=523). We classified hypertension as controlled, undertreated, or treatment resistant at 3 months after ICH and determined the following: (1) the risk factors for uncontrolled hypertension and (2) whether hypertension control at 3 months is associated with stroke recurrence and mortality. We followed 1828 survivors of ICH for a median of 46.2 months. Only 9 of 234 (4%) recurrent strokes occurred before 3 months after ICH. At 3 months, 713 participants (39%) had controlled hypertension, 755 (41%) had undertreated hypertension, and 360 (20%) had treatment‐resistant hypertension. Black, Hispanic, and Asian race/ethnicity and higher blood pressure at time of ICH increased the risk of uncontrolled hypertension at 3 months (all P<0.05). Uncontrolled hypertension at 3 months was associated with recurrent stroke and mortality during long‐term follow‐up (all P<0.05). CONCLUSIONS: Among survivors of ICH, >60% had uncontrolled hypertension at 3 months, with undertreatment accounting for the majority of cases. The 3‐month blood pressure measurements were associated with higher recurrent stroke risk and mortality. Black, Hispanic, and Asian survivors of ICH and those presenting with severe acute hypertensive response were at highest risk for uncontrolled hypertension. John Wiley and Sons Inc. 2021-05-15 /pmc/articles/PMC8483505/ /pubmed/33998241 http://dx.doi.org/10.1161/JAHA.120.020392 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Biffi, Alessandro Teo, Kay‐Cheong Castello, Juan Pablo Abramson, Jessica R. Leung, Ian Y. H. Leung, William C. Y. Wang, Yujie Kourkoulis, Christina Myserlis, Evangelos Pavlos Warren, Andrew D. Henry, Jonathan Chan, Koon‐Ho Cheung, Raymond T. F. Ho, Shu‐Leong Anderson, Christopher D. Gurol, M. Edip Viswanathan, Anand Greenberg, Steven M. Lau, Kui‐Kai Rosand, Jonathan Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title_full | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title_fullStr | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title_full_unstemmed | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title_short | Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage |
title_sort | impact of uncontrolled hypertension at 3 months after intracerebral hemorrhage |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483505/ https://www.ncbi.nlm.nih.gov/pubmed/33998241 http://dx.doi.org/10.1161/JAHA.120.020392 |
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